Lymph nodal cyst-like lesions are occasionally identified during abdominal ultrasound in dogs. However, a study evaluating their prevalence and clinical significance is lacking. The aim of this ... [more ▼]

Lymph nodal cyst-like lesions are occasionally identified during abdominal ultrasound in dogs. However, a study evaluating their prevalence and clinical significance is lacking. The aim of this observational cross-sectional study was to evaluate prevalence, most common location and concurrent diseases of cyst-like lymph nodes detected during abdominal ultrasound. Affected lymph nodes, patient signalment and concurrent diseases of dogs with cyst-like lymph nodal lesions having undergone abdominal ultrasound over a one-year period were recorded. Twenty-three affected lymph nodes were observed in 17/553 dogs (prevalence=3 per cent). The most commonly affected was the lumbar lymphocenter (7/23), followed by the coeliac (6/23), the cranial mesenteric (5/23) and the iliosacral (5/23). Twenty-three concurrent diseases were diagnosed in 17 dogs, among which 16/23 were non-neoplastic (70 per cent). The most common concurrent disease was renal insufficiency (8/23), followed by neoplasia (7/23), gastroenteropathy (3/23), benign prostatic disease (2/23), pancreatitis (1/23), peritonitis (1/23) and neurological disease (1/23). No statistical correlation existed between cyst-like lymph nodal lesion and a specific neoplastic or non-neoplastic disease. In conclusion, in the present study, cyst-like lymph nodal lesions have a low prevalence, involve different lymphocenters and were found in dogs affected by different diseases, including both non-neoplastic and neoplastic aetiologies. [less ▲]

Introduction/Purpose Comparison learning is an approach for learning complex visual tasks. As described in human medicine, by comparing radiographs with pathology and without pathology, veterinary ... [more ▼]

Introduction/Purpose Comparison learning is an approach for learning complex visual tasks. As described in human medicine, by comparing radiographs with pathology and without pathology, veterinary students could learn to discriminate relevant disease-related information to recognize the disease. We hypothesized that exposure to a training by side-by-side comparison of normal to abnormal radiographs would lead to higher visual diagnostic accuracy and possibly to a higher ability to describe the features of a known disease on canine thoracic radiographs. Material and methods Twenty veterinary students were randomly assigned to either a group that compared radiographs showing thoracic disease with normal images (group 1) or to a group that only studied abnormal radiographs (group 2). All students had their theoretical radiology teaching and 13 of them had also received the practical teaching of the study curriculum, evenly distributed between the 2 groups. Twenty-nine radiographs of small animal thorax were used. The procedure consisted in three experimenter-supervised phases: 1. training, 2. visual recognition test, 3. feature description test. In the training phase, each screen showed two radiographs with the name of the disease present in each. In the group 1 (pathology/normal condition), a radiograph of a patient and a normal image were shown next to each other. In the group 2 (pathology/pathology condition), two radiographs of patients with the same disease were shown next to each other. The 9 screens were presented twice, with the diseases in a different order for the first and second runs. A Mann-Whitney test was used to compare the success rates of groups of students. Results On visual recognition test, there was no statistical difference in visual diagnostic accuracy between groups. When students gave the wrong answer, they often diagnosed the item as another disease of similar distribution (diffuse or focal). Students who received the practical teaching and students of group 1 had a higher accuracy for normal thoracic radiographs. On feature description test, no significant effect of comparison learning was found, but focal diseases were better described than diffuse diseases with a significant difference between these. Discussion/Conclusions Results show that comparison with normal images did not help in recognizing or describing thoracic pathologies but helps to recognize normal images. [less ▲]

SUMMARY Percutaneous ultrasound guidance has become a routine procedure in veterinary medicine in domestic animals. It allows precise placement of the needle in the desired target. Punctures of the ... [more ▼]

SUMMARY Percutaneous ultrasound guidance has become a routine procedure in veterinary medicine in domestic animals. It allows precise placement of the needle in the desired target. Punctures of the subarachnoid space in dogs are frequently carried out in veterinary practice for diagnostic purposes. In these procedures, the placement of the needle into the subarachnoid space (atlanto-occipital or lumbar) is commonly performed blindly by feeling the bony anatomical landmarks but this can be laborious or even impossible in some patients as reported in human medicine. The topic of this study is ultrasound guidance for the placement of the needle during puncture of the subarachnoid space. The needle placement can be done under ultrasound guidance according to two methods. The "indirect guidance" is a method of deferred ultrasound guidance. The "direct guidance" is a real time procedure in which the operator holds the needle in one hand and the ultrasound probe in the other. It allows direct visualization of the needle (if direct guidance), the target structure, adjacent tissues (including vascular structures) and potential injectate while minimizing the risk of complications. Punctures of the subarachnoid space are carried out by placing the needle in the cisterna magna or in the caudal lumbar subarachnoid space (between the fifth and sixth lumbar vertebrae). The cisternal puncture is most frequently used in practice but presents greater risk of iatrogenic lesions of the brain stem. The lumbar puncture is technically more difficult and is frequently contaminated by iatrogenic blood. Cerebrospinal fluid punctures have several clinical applications. They allow to collect cerebrospinal fluid for diagnostic testing, to realize myelograms or myeloscanners by injecting contrast medium and to perform spinal anesthesia or analgesia by injecting one or more substance(s) blocking the conduction of the spinal nerves. Subarachnoid lumbar puncture is used commonly in the dog for cerebrospinal fluid collection and/or myelography. Percutaneous ultrasound anatomy of the lumbar region in the dog and a technique for ultrasound-guided lumbar puncture were described in the first study. Ultrasound images obtained ex- vivo and in-vivo were compared with anatomic sections and used to identify the landmarks for ultrasound-guided lumbar puncture. The ultrasound-guided procedure was established on cadavers and then applied in-vivo on eight dogs. The anatomic landmarks for the ultrasound-guided puncture, which should be identified using the parasagittal oblique ultrasound image, were the articular processes of the fifth and sixth lumbar vertebrae and the interarcuate space. The spinal needle was directed under direct ultrasound-guidance toward the triangular space located between the contiguous articular processes of the fifth and sixth lumbar vertebrae and then advanced to enter the vertebral canal. Using these precise ultrasound anatomic landmarks, an ultrasound-guided technique for lumbar puncture is applicable to dogs. Cisternal puncture in dogs and cats is commonly carried out. Percutaneous ultrasound anatomy of the cisternal region in the dog and the cat and an indirect technique for ultrasound-guided cisternal puncture were described in the second study. Ultrasound images obtained ex-vivo and in-vivo were compared with anatomic sections and used to identify the landmarks for ultrasound-guided cisternal puncture. The ultrasound-guided procedure was established in cadavers and then applied in- vivo in seven dogs and two cats. The anatomic landmarks for the ultrasound-guided puncture were the cisterna magna, the spinal cord, the two occipital condyles on transverse images, the external occipital crest and the dorsal arch of the first cervical vertebra on longitudinal images. Using these ultrasound anatomic landmarks, an indirect ultrasound-guided technique for cisternal puncture is applicable to dogs and cats. The standard technique for placing a needle into the canine lumbar subarachnoid space is primarily based on the palpation of anatomic landmarks and the use of probing movements of the needle. However, this technique can be challenging for novice operators. The aim of the third observational, prospective, ex vivo, feasibility study was to compare ultrasound-guided versus standard anatomic landmark approaches for novices performing needle placement into the lumbar subarachnoid space using dog cadavers. Eight experienced operators validated the canine cadaver model as usable for training landmark and ultrasound-guided needle placement into the lumbar subarachnoid space based on realistic anatomy and tissue consistency. With informed consent, 67 final year veterinary students were prospectively enrolled in the study. Students had no prior experience in needle placement into the lumbar subarachnoid space nor use of ultrasound. Each student received a short theoretical training about each technique before the trial and then attempted blind landmark-guided and ultrasound-guided techniques on randomized canine cadavers. After having performed both procedures, the operators completed a self-evaluation questionnaire about their performance and self-confidence. Total success rates for students were 48% and 77% for the landmark- and ultrasound-guided technique, respectively. Ultrasound guidance significantly increased total success rate when compared to the landmark-guided technique and significantly reduced the number of attempts. With ultrasound guidance self-confidence was improved, without bringing any significant change in duration of the needle placement procedure. Findings indicated that the use of ultrasound guidance and cadavers is a feasible method for training novice operators in needle placement into the canine lumbar subarachnoid space after short theoretical training. Ultrasound-guided techniques for needle placement in the cisterna magna and in the lumbar subarachnoid space were described in the dog. The aim of the fourth observational, prospective, ex-vivo study was to compare the impact of ultrasound guidance for the cisternal versus lumbar needle placement using dog cadavers. With informed consent, 83 operators were prospectively enrolled in the study. They were divided in four groups depending on experience. Each operator received a short theoretical training about each technique before the trial and then attempted a cisternal and lumbar punctures with blind landmark-guided and ultrasound-guided techniques on randomized canine cadavers. The lumbar ultrasound-guidance was direct while the cisternal ultrasound-guidance was indirect. After having performed each procedure, the operators completed a self-evaluation questionnaire about their previous experience, their performance and their self-confidence. The ultrasound guidance significantly increased total success rate in both areas compared with the blind technique but more significantly in the lumbar region. The cisternal ultrasound guidance significantly improved the number of attempts, the time needed to perform the procedure and the self-confidence in inexperienced and experienced operators. The lumbar ultrasound guidance significantly increased the self-confidence in inexperienced and experienced operators and significantly decreased the number of attempts in inexperienced operators. The first cause of failure cited was different according to the location of the puncture and was related to the nature of ultrasound guidance. Findings indicated that the use of ultrasound guidance by novice and experienced operators improved different parameters according to the location of the needle placement. This study demonstrated that inexperienced operators are able to use ultrasound guidance after a short theoretical teaching session in an ex-vivo context and this supports the use of ultrasound-guidance for learning and teaching purposes. The study of the impact of ultrasound guidance for needle placement procedures described in this work could be developed and studied for other technically difficult or risky procedures on dogs. If the benefits of ultrasound guidance demonstrated ex-vivo in this work are transferable to the clinical conditions, punctures of the subarachnoid injections would be less « scary » for novice operators and become routine procedures applicable by a large numbers of veterinarians. [less ▲]

The standard technique for placing a needle into the canine lumbar subarachnoid space is primarily based on palpation of anatomic landmarks and use of probing movements of the needle, however, this ... [more ▼]

The standard technique for placing a needle into the canine lumbar subarachnoid space is primarily based on palpation of anatomic landmarks and use of probing movements of the needle, however, this technique can be challenging for novice operators. The aim of the current observational, prospective, ex vivo, feasibility study was to compare ultrasound-guided vs. standard anatomic landmark approaches for novices performing needle placement into the lumbar subarachnoid space using dog cadavers. Eight experienced operators validated the canine cadaver model as usable for training landmark and ultrasound-guided needle placement into the lumbar subarachnoid space based on realistic anatomy and tissue consistency. With informed consent, 67 final year veterinary students were prospectively enrolled in the study. Students had no prior experience in needle placement into the lumbar subarachnoid space or use of ultrasound. Each student received a short theoretical training about each technique before the trial and then attempted blind landmark-guided and ultrasound-guided techniques on randomized canine cadavers. After having performed both procedures, the operators completed a self-evaluation questionnaire about their performance and self-confidence. Total success rates for students were 48% and 77% for the landmark- and ultrasound-guided techniques, respectively. Ultrasound guidance significantly increased total success rate when compared to the landmark-guided technique and significantly reduced the number of attempts. With ultrasound guidance self-confidence was improved, without bringing any significant change in duration of the needle placement procedure. Findings indicated that use of ultrasound guidance and cadavers are feasible methods for training novice operators in needle placement into the canine lumbar subarachnoid space. [less ▲]

Background Early recognition of left-sided congestive heart failure (CHF) in dogs with degenerative mitral valve disease (DMVD) is important because it influences medical therapy, timing of follow-up, and ... [more ▼]

Background Early recognition of left-sided congestive heart failure (CHF) in dogs with degenerative mitral valve disease (DMVD) is important because it influences medical therapy, timing of follow-up, and outcome.HypothesisPulmonary vein diameter-to-pulmonary artery diameter ratio (PV/PA) measured by echocardiography can predict CHF.AnimalsNinety-eight client-owned dogs, 37 controls, and 61 dogs with DMVD.Methods Prospective clinical cohort study. History, physical examination and Doppler-echocardiography were performed. Dogs were classified as International Small Animal Cardiac Health Council class I, II or III. Congestive heart failure was identified in a subset of 56 dogs based on radiographic findings. The PV/PA was measured in bidimensional (2D) and M-mode by 2 investigators blinded to the radiologists’ conclusions.ResultsInterobserver coefficients of variation for PV/PA acquisition and measurement were <10%. The PV/PA in control dogs was approximately 1 and increased with class of heart failure. The presence of CHF could be best predicted by measuring PV/PA in 2D echocardiography (cut-off, 1.7; area under the curve, 0.98; CI, 0.97–0.98; P < .001) with a sensitivity of 96% and a specificity of 91%.Conclusion and clinical importanceThe PV/PA is a simple and reproducible echocardiographic variable that increases with class of heart failure and may help discriminate dogs in CHF from asymptomatic dogs with DMVD. Additional studies are required to determine whether PV/PA might provide additional information in the integrated interpretation of Doppler-echocardiographic indices of left ventricular filling pressures and could be used for rapid assessment of CHF in dogs in a critical care setting. [less ▲]

in Veterinary radiology & ultrasound : the official journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association (2015)

An accurate method for guiding injections into the canine hip would facilitate diagnostic localization of lameness and targeted treatments. Ultrasound-guided hip injections are commonly used in humans and ... [more ▼]

An accurate method for guiding injections into the canine hip would facilitate diagnostic localization of lameness and targeted treatments. Ultrasound-guided hip injections are commonly used in humans and large animals. Aims of this prospective study were to describe ultrasound (US) anatomy of the adult canine hip and determine the feasibility and accuracy of intra-articular placement of injectate using US-guidance. Seven adult dogs were used to describe US anatomy, five dog cadavers were used to assess the feasibility of the injection technique and 11 dog cadavers were used to assess accuracy of injections. For the accuracy test, 22 joints were injected with iodinated contrast medium by three operators with different experience. With dogs in lateral recumbency, the hyperechoic femoral head surface was identified by following the femoral neck from the greater trochanter or the acetabular rim was localized by following caudally the ilium from the iliac wing. An anechoic gap between the femoral head and acetabular surface represented the joint. The capsule was visible as a triangular echoic structure and the femoral head articular cartilage appeared as an anechoic band. The needle was inserted axial to the greater trochanter and directed in a dorsolateral-ventromedial direction toward the joint space and then pushed through the capsule. Based on postinjection radiography, accuracy was 81.8% at first attempt and 100% at second attempt. This study indicated that US-guided injection is a feasible and accurate technique for injecting the adult canine hip. Future studies in live dogs are needed to assess safety and efficacy. [less ▲]

Background: In the dog, neoplasms of the lacrimal gland are rare. Lacrimal cysts were also reported. Computed tomography (CT) scan findings of these lacrimal gland abnormalities have not been described in ... [more ▼]

Background: In the dog, neoplasms of the lacrimal gland are rare. Lacrimal cysts were also reported. Computed tomography (CT) scan findings of these lacrimal gland abnormalities have not been described in dogs. Purpose: The present report describes clinical and CT features of a lacrimal gland tumor in a dog. Methods: A 3,5 year old female intact Leonberger with a good general health status was presented with a progressive swelling at the level of the supero-temporal area of the left upper eyelid and of the bulbar conjunctiva since 3 weeks. Ocular examination revealed a slight enophthalmia and a ventronasal strabismus, the presence of a firm mass in the upper eyelid which was anteriorly well circumscribed and extending posteriorly between the globe and the orbital ligament. Findings: A CT scan pre- and post- contrast studies of the head were performed. A 3 cm hypoattenuating (+/- 10 HU) ovoid mass was observed dorsolateral to the indented left globe. This mass was well circumscribed by an unevenly thick irregular soft tissue- attenuating wall (50HU), which was strongly contrast-enhanced (150HU) and measured about 2 to 10mm in thickness. The left globe was displaced caudoventromedially. No adjacent bone lesion, or foreign body was observed. No normal left lacrimal gland was observed. These findings were suggestive of an abscess or an orbital tumor with a necrotic/cystic center; a lacrimal cyst was considered less likely because of the unevenness and the thickness of the wall. Complete surgical ablation was done by a modified lateral orbitotomy. Histopathology revealed a mixed benign tumor of the lacrimal gland and a lymphocytic necrotic adenitis. Six months postoperatively no recurrence is noted and the tear production is 15mm/min. Conclusion: The lacrimal gland is located dorsolateral to the globe and produces tears. In human medicine, a wide range of lacrimal gland pathologies were described and assessed by computed imaging techniques. Pleomorphic adenomas (mixed benign tumor) could reveal irregular bone erosion and could undergo malignant transformation. In dogs, lacrimal cysts were described as thin walled structures.4 Only few articles reported lacrimal gland tumor. To the authors knowledge, CT findings of a lacrimal gland tumor have not been described previously. In conclusion, lacrimal gland tumor should be included in the differential diagnosis of a firm ovoid cystic/necrotic mass dorsolateral to the orbit. [less ▲]

Introduction Ultrasound (US)-guided techniques are routinely used in human1,2 and veterinary3 medicine to increase safety and accuracy1. Due to its deep location blind needle insertion in the coxo-femoral ... [more ▼]

Introduction Ultrasound (US)-guided techniques are routinely used in human1,2 and veterinary3 medicine to increase safety and accuracy1. Due to its deep location blind needle insertion in the coxo-femoral joint may be difficult. The aim of this study was to determine the US anatomy of the adult canine hip in order to establish the approach for US-guided intra-articular (IA) injections. Materials and Methods A 3-18 MHz linear and a 5-10 curvilinear transducers were used. Seven adult live dogs were used to establish the US anatomy. Ten dog cadavers were used to obtain frozen sections to compare to US images and to establish the injection technique. Dogs were clipped and examined in lateral recumbency using a dorsal approach. To assess accuracy of injections performed on cadavers, joints were injected with a iodinated contrast medium and controlled radiographically. Injections were realized by 3 operators with different US experience using a 22G needle. To localize the joint, two techniques were established: one using the greater trocanther as landmark, one using the ilium wing. Results The coxo-femoral joint was easily visualized in all live dogs and cadavers. When the great trochanter was used as anatomical landmark, the femoral neck hyperechoic surface was identified in continuity with the greater trocanther hyperechoic surface in a plane perpendicular to the vertebral column and then followed axially till the anechoic gap representing the articular space. At the joint space the hyperechoic acetabulum was seen partially covering the femoral head and the joint capsule was visible as a triangular echoic structure (Figs. 1 & 2). Using the hyperechoic surface of the ilium wing as a starting point, the coxofemoral joint was localized following the wing and the hyperechoic ilium body caudally in a transverse plane. The inexperienced operator found easier to localize the joint using the ilium as landmark. For injection the needle was inserted axially to the great trochanter and directed in a dorsolateral-ventromedial direction toward the joint space and then pushed through the capsule (Figs. 3 & 4). Twenty hips were injected (Fig. 5). In all cases operators had the feeling to pass the joint capsule with the needle. All injections were successful and control radiographs showed intra-articular contrast (Fig. 6). Discussion/Conclusion The dorsal aspect of the canine hip can be easily localized at US and US-guidance can be efficiently used for IA injection [less ▲]

Ultrasonography of the cisterna chyli has been used in humans to diagnose increased lymphatic flow or lymph flow obstruction and to guide percutaneous embolization of the thoracic duct via the cisterna ... [more ▼]

Ultrasonography of the cisterna chyli has been used in humans to diagnose increased lymphatic flow or lymph flow obstruction and to guide percutaneous embolization of the thoracic duct via the cisterna chyli. The aim of this study was to describe the ultrasonographic characteristics of the dorsal portion of cisterna chyli in dogs and cats with chylous ascites or chylothorax and in a group of healthy dogs and cats. The aorta and the cranial mesenteric artery were used as anatomic landmarks. Ultrasonography was performed before and 2 h after a fatty meal in healthy dogs and cats. The visualized structure was confirmed to be a dilated cisterna chyli at necropsy in a dog with chylous ascites. The confirmed or presumed cisterna chyli was consistently detected using ultrasonography in nonfasted healthy animals and clinically affected animals and appeared as an anechoic tubular structure, without detectable flow, at the right dorsolateral aspect of the aorta. It had a similar ultrasonographic appearance in patients with chyloabdomen and in nonfasted healthy dogs and cats. There was considerable overlap in diameters of the cisterna chyli for affected and healthy animals. The shape and size of the cisterna chyli in an individual animal were variable during the same ultrasound examination and between different examinations. This study demonstrated the appearance of the presumed dorsal portion of the cisterna chyli by ultrasonography and might provide useful preliminary data for further studies into the feasibility of ultrasound-guided injections or aspirations of the cisterna chyli in dogs and cats. [less ▲]